Oligoovulation is typically defined as infrequent or irregular ovulation. During menstruation, follicles develop into eggs in the ovaries, in which normally, one egg matures faster and is released while the rest degenerate. Superovulation is when more than one follicle is developed into mature eggs. Oligomenorrhea is typically defined as infrequent, often light menstrual periods (intervals exceeding 35 days). Amenorrhea is the absence of a menstrual period in a woman of reproductive age. Oligoovulation, Oligomenorrhea and Amenorrhea are common in conditions such as PolyCystic Ovary Syndrome (PCOS), one of the most common female endocrine disorders. PCOS is a disorder in which eggs do not get released during ovulation. Instead of the follicle breaking open to release mature eggs immature follicles group together to form large cysts or lumps. The eggs mature within the follicles, but the follicles do no break open to release the mature eggs. PCOS produces oligoovulatory and oligomenorrheic symptoms in approximately 5% to 10% of women of reproductive age (12-45 years old). It is thought to be one of the leading causes of female subfertility and the most frequent endocrine problem in women of reproductive age. The symptoms and severity of the syndrome vary greatly among affected women.
There is no cure or treatment for PCOS. The medical field has many options for managing the symptoms of PCOS. The Management of polycystic ovary syndrome focuses on infertility, hirsutism, acne, and cardiovascular risks such as obesity, high blood cholesterol, diabetes, and high blood pressure.
For fertility and pregnancy, the medical field focuses on triggering ovulation by using an anti-estrogen medication such as Clomiphene alone or in combination with Metformin or injections of gonadotropins.
For regular menstruation without pregnancy, countering against endometrial cancer, the medical field would prescribe a low-dose contraceptives combined with synthetic estrogen and progesterone or an alternative approach of taking progesterone for 10 to 14 days each month to regular the menstrual cycle.
For insulin resistance, typically, the medical field would prescribe Metformin which is prescribed to treat Type 2 Diabetes and treating insulin resistance.
While Polycystic Ovarian Syndrome is the most common cause of female fertility, it is directly related to Type 2 Diabetes which is a metabolic disorder that occurs when there is an insulin disorder caused by either the pancreas not producing enough of the hormone insulin or the body stops responding to insulin. It is believed that high levels of insulin contribute to increased production of androgen which worsens the symptoms of PCOS. The medical field prescribes medications to reduce androgen levels and birth control pills to regulate menstruation; preventing further medical complications. Progestins and insulin sensitizing medications are prescribed to induce menstrual period and restoring normal cycles.
The last resort option of treating PCOS is a surgery called ovarian drilling to treaty PCOS which is a small incision to puncture the ovary and destroy small portion of the ovary to improve the hormone levels and ovulation.
In the treatment of controlling the symptoms of PCOS, Diet and exercise is often recommended to reduce the risk of developing diabetes and/or heart disease. Following a special diet is a vital aspect in PCOS care. Hence, managing blood sugar level via diet combined with moderate exercise can often help in reducing the response of insulin and improves insulin resistance.
Thus there is a present and continuing need for new emmenagogues for the treatment of Oligoovulation, Oligomenorrhea and Amenorrhea.